In-Hospital Cardiac Arrest: Best Practices

John D. Kim, MD, Daniel D. Dressler, MD, MSc, FHM

An American Heart Association consensus statement offers guidance on prevention, management, and postevent care.

Responding to documented improvement in in-hospital cardiac arrest outcomes (NEJM JW Hosp Med Nov 14 2012), the American Heart Association (AHA) gathered an expert panel to summarize the data and offer best practice recommendations about structural, pathway, and process aspects of in-hospital prearrest, intra-arrest, and postarrest evaluation and care (table). Efforts focus on such quality-care measures and practices as rapid response teams (prearrest), optimal chest compressions and early defibrillation (intra-arrest), and therapeutic hypothermia (postarrest).

The expert panel also focused on changing the cultural perception among healthcare providers that resuscitative efforts are futile. Lack of knowledge and lack of uniform reporting standards might lead to impatience and early withdrawal of life-sustaining therapy. Culture change through accurate reporting, knowledge expansion, and systems training should improve outcomes.

Citation(s):

Morrison LJ et al. Strategies for improving survival after in-hospital cardiac arrest in the United States. 2013 Consensus Recommendations: A consensus statement from the American Heart Association. Circulation 2013 Apr 9; 127:1538.